Inflammation is the foundation for cancer and degenerative/autoimmune diseases. Small changes in diet and exercise, e.g. omega-3 oils, vitamin D, low starch, and maintaining muscle mass, can dramatically alter predisposition to disease and aging, and minimize the negative impact of genetic risks. Based on my experience in biological research, I am trying to explain how the anti-inflammatory diet and lifestyle combat disease. 190 more articles at http://coolinginflammation.blogspot.com

Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:

Thursday, June 17, 2010

Speculation on the cause of infant reactions to cow’s milk in formula or transmitted into mother’s milk. Are mother’s priming their newborns in utero with antibodies to react to non-human sugars (Neu5Gc)?

Sialic Acids Mark the Surface of Human Cells

Human cells are covered with a forest of long and short carbohydrates, polysaccharides and oligosaccharides resp., which control the interaction of the cells with the outside world. The sugars exposed on the ends of these sugar chains are sialic acids. It is not surprising that pathogenic viruses and bacteria target sialic acids as the first step in attacking human cells and that policing immune cells avoid attacking their own cells by recognizing the sialic acids. The surprise is that essentially all other mammals have the same two sialic acids, Neu5Ac and Neu5Gc, but humans have only Neu5Ac. Meat and cow’s milk have both. Babies and mother’s milk should have only Neu5Ac.

Evolution to Lose Neu5Gc to Avoid Pathogens

Surviving defective remnants of genes needed to make Neu5Gc suggest that loss of Neu5Gc was an adaptation to avoid general mammalian pathogens and to facilitate brain development. One of the limitations of using other mammals as models of human diseases is the differences in sialic acids that are commonly used for initial docking of pathogens on human cells. Other mammals have different forms of malaria than humans and we are well aware that influenza adapted to birds and pigs does not infect humans without adjusting to the lack of Neu5Gc.

Antibodies Against Neu5Gc

Humans make antibodies to Neu5Gc when injected with blood products from other mammals. A sudden change from a long term vegan diet to a meat diet can also lead to the production of anti-Neu5Gc antibodies. These types of antibodies may contribute to some types of non-lactose milk intolerance/allergies.

Neu5Gc from Cow’s Milk Gangliosides to Mother’s Milk

A significant problem in infant health is the reaction of the infant with abdominal distress after eating cow’s milk-based formula or in some cases from breastfeeding after the mother has eaten milk or other dairy products. Milk oligosaccharides, proteins and lipids have Neu5Gc. It is unlikely that cow’s milk proteins or oligosaccharides can move from the mother’s intestines to her breast milk, but it is possible that Neu5Gc attached to fatty acids in the form of gangliosides may be transferred to breast milk.

Mother’s Anti-Neu5Gc in Infants Gut Reacts with Cow Neu5Gc

If cow’s milk gangliosides are the source of Neu5Gc in breastmilk, then how do the infants develop antibodies to these relatively rare antigens? Babies receive all of their antibodies from their mother until their immune systems start to develop at about six months of age. The answer is hinted at by the observation of a mother whose exclusively breastfed infant developed sensitivity to breast milk after the mother ate dairy products. The mother reported that she shifted from a long term vegan diet to a meat diet to improve her nutrition during her pregnancy. It is also likely that she produced IgE antibodies to Neu5Gc, which were then transferred to her baby across the placenta during gestation.

Anti-Neu5Gc Antibodies May Explain Infant Milk Intolerance and Colic

Infants with anti-Neu5Gc antibodies obtained from their mother during gestation in utero, will have mast cells in the lining of their gut that are primed to react to Neu5Gc in cow’s milk present as components in formula or in trace amounts transferred into breast milk. Infants may respond to these immunological reactions with a variety of symptoms, including those observed as rejection of formula or breast milk after the mother has eaten dairy products or as colic.

80 comments:

shutchings
said...

Okay, I tried to follow it all, but based on everything you wrote, what exactly would you recommend to those who would like to avoid a colicky baby--and do you have any suggestion as to why colic seems to magically end almost to the day they turn one year old?

Merrybee,I doubt that your intolerance of beef and dairy is immunological. It is more likely the same as most "food allergies" and intolerances, the inability of your gut flora to handle the food. These intolerances are treated by gradually adapting your gut bacteria to the nutrients in the food.

Yeast infections of the intestine, candidiasis, is another typical contributor to food intolerances.

Intolerance of fat may result from depletion of bile by inadequate dietary fat. Many people on modern diets suffer from inadequate saturated fat. The biomedical literature never actually documented that saturated fat had health disadvantages and inflammatory polyunsaturated vegetable oils were substituted. Low fat foods are more of a problem than the whole foods that they replaced.

shutchings,I tried to explain the cause of some milk allergies and colic, but of course that doesn't quiet the crying baby.

After the baby is crying, I would recommend the 5 S's approach that is outlined in Wikipedia under "colic." These are designed to recreate the soothing environment of the womb. I ran across most of these tactics when I was trying to get my three daughters back to sleep while rocking them a couple of decades ago.

I think that colic suddenly stops when the infant's immune system finally matures enough to stifle inappropriate responses. That takes about a year.

Does this mean that if you haven't been eating meat or drinking cows milk before the pregnancy, they should be avoided during pregnancy? I assume that if your diet had these things prior to pregnancy there would be no problem continuing them. Correct?

Anonymous,I think that most women who are not eating meat or dairy have numerous deficiencies that make pregnancy more problematic. The biggest problem from my perspective, as one might guess, is chronic inflammation.

Since suppression of inflammation is required to get and maintain a pregnancy, chronic inflammation can contribute to infertility, miscarriage and prematurity. It would be wise to avoid diet-based chronic inflammation before trying to become pregnant. The problem would come if a woman already displayed symptoms of chronic inflammation (food allergy, autoimmune disease, acne, depression, etc.) and then tried to switch to a meat/dairy diet.

The combination of inflammation plus a diminished gut flora leading to a defect in the immune system that supports allergies and autoimmune diseases would be the wrong time to add new antigens.

If you are already eating meat and dairy, then they should continue to be healthy foods during pregnancy. It would also, of course, be wise to consume a normal anti-inflammatory diet with healthy gut flora before, during and after a pregnancy.

Also, if you are planning to get pregnant, it is time to start thinking about baby health and realize that many modern cultures and medical systems are not very supportive of breastfeeding and you will need to develop your own support system to minimize the impact of the commercial onslaught of the formula companies. Formula is the most extreme presentation of milk allergens in an inflammatory environment. [Sorry for the harangue, but this is a major contributor to disease in most health systems.]

Anonymous,That Science Daily article is by the same group that has shown the ties between segmented gut bacteria and Th17 development in the gut. This is pointing toward the complete picture of Il-2 deficiency and uncontrolled Il-17 expression in tissue leading to autoimmune disease. It is all controlled by gut bacteria. The paper should be out in a couple of days.

I posted a few weeks ago about my baby boys colicky response when I consume dairy products. However, I have not tested yogurt or kefir alone (after removing all other dairy). I am wondering if fermentation of dairy would change the proteins or other substances that the baby reacts to? I believe traditionally most cultures consumed soured milk.

Also, from my own experiences with two children, and after talking to other mothers with similar problems, babies reacting to a mothers breastmilk after she has had dairy is frequently in women who have consumed meat and/or milk during and prior to pregnancy. However, I do think that inflammation plays a large part in this. Perhaps ceoliac disease or gluten intolerance (that is mild enough that the mother is unaware of it other than occasional IBD) also has something to do with creating a gut environment that is intolerant of milk that is passed on to the baby? For babies that react with abdominal distress to milk allergy, it is very difficult to soothe them and most methods such as the "football hold", bouncing on an exercise ball while holding them, or a warm bath are only temporary. They also typically have trouble sleeping in stretches longer than 2 hrs, sometimes as short as 45 min.

Sarah,I would suspect gut inflammation and disruption of the tolerance system in the gut associated lymph tissue (GALT) by disruption of gut flora as a prelude to the IgE production against cow's milk. This would set the stage for priming the kid's gut mast cells with IgE before it is born and having a lasting impact until the kid produces its own antibodies.

A modern inflammatory diet (which encourages allergies and autoimmune disease) is all that is needed to prime the mother for a change in diet to beef or dairy. I don't think that fermentation will make much difference if the mother has never had dairy. If the mother is used to fermented dairy products, then her gut flora would be nicely developed and she and her babies would not have any problems.

Anonymous,I think that there is probably a way to remove Neu5Gc from cow's milk and formula, but what is the point?

It is much easier and natural for people (mothers in this case) to change their unhealthy diets. The consequences of colic and allergies in infants can be avoided if mothers have healthy, non-inflammatory diets to begin with. A significant portion of the high infant mortality and sickness in the USA is due to common inflammatory diets that are supported by the healthcare and food processing industries.

The answers to healthcare are in elimination of inflammatory components of the modern diet: vegetable oils, grain-based products, sugar/HFCS. The myths of our systems, high carb diets, avoiding sun exposure, polyunsaturated vs. saturated fats, carbonated drinks, simply make us prone to our common inflammatory and autoimmune diseases.

I have a brief question regarding immunity. Please don't feel obligated to answer at length -- you are far too accomodating to your many blog readers.

My wife is a teacher and struggles with a weak immune system, particularly in the winter. Her bane is sinus infections -- it's as though she has no resistance to them. Because the infections have mostly been treated with antibiotics, I imagine that her gut flora are totally out of whack (though she has no digestive issues). Besides your general anti-inflammatory approach (which we are both taking) is there anything that could help boost her immunity? Probiotic dairy on an empty stomach seems a good start, and she read about beta-glucans and takes that (I don't know what they are) but I feel at a bit of a loss about how to help her -- the whole issue, as I understand from reading your blog, is very complicated. As a teacher, I know she won't avoid illness, but it seems there must be some way to have a better quality of life than she does. Whatever advice you have to give I'd appreciate but, again, don't feel like you have to write at length -- a few suggestions will suffice.

Sinus infections are hard to treat with antibiotics, because the bacteria are conveniently, for them, isolated from the blood flow/immune system and the increased mucus blocks nitric oxide access in the breath. Humming is the best approach (look up my article in Suite101 on the subject.)

Beta glucans are probably not a good idea, because they merely aggravate the immune system.

Has your wife actually had her serum vit.D checked? She is probably low.

She probably has had a major thinning out of her gut flora. Probiotics are good for a start, but I would also recommend a variety of greens/spices/herbs. She should have wonderful access to a variety of bacteria, unfortunately most of them are from people with unhealthy diets.

That's about as brief as I can be and still have a little fun with it. I didn't even discuss my work in grad school on the determining some of the first structures of the beta-glucans from fungi.

@Ben - I've had good luck eliminating sinus infections using a Neti pot. Fill it with warm water and some salt when not sick (instructions come with the pot), but if an infection is present then put several drops of Lugol's iodine in the pot and irrigate the sinuses with that. Hope this helps,Laurel

Ben,I think that a "hum" is humming on a breath full of air, ca. 5-10 sec. I think that the point is to break up the boundary layer of mucus next to the lining of the sinus to permit the breath NO to dilate the capillaries and bring the immune system (cells, lactoferrin, defensins, etc.) in contact with the infection.

NO is probably involved in allergic rhinitis or nasal allergies, but it is probably useful. Both of those allergic reactions indicate chronic inflammation and inadequate suppressor T cell function, which indicates an inflammatory diet problem (at least in the past to produce the antibodies) and a gut flora disfunction.

Gum disease is another common source of inflammation.

Humming and rinsing might be a good preventive practice, supported by diet to nourish body and gut flora.

Hi Dr Ayers,I am planning to become pregnant and have been following your guidelines on an anti inflammatory diet. I've tried to build up my good bacteria by eating fresh salads from the garden, taking probiotics, and avoiding processed foods and vegetable oils. After reading your post on dairy intolerance, I have recently started drinking raw milk and yoghurt after having avoided these due to an intolerance for years. Do you have any idea how long it takes for gut flora to adapt to dairy, ie how long do I have to wait before I can become pregnant and not pass problems on to my baby?thanks for you all the info it's completely life changing

Obvious risk would be a vegan who wants to improve nutrition for a pregnancy by shifting to meat/dairy.

If you have been eating meat and are not constipated and do not have allergies or autoimmune diseases, then your chances of the anti-Neu5Gc scenario are minimal.

If you have been eating meat and shift to dairy, I would expect you to adapt in a couple of weeks eating yogurt with live bacteria. This should overcome lactose intolerance. You could also increase the likelihood of adapting quickly by taking probiotics.

The diet I recommend is also good for enhancing fertility and avoiding preeclampsia and prematurity. Also remember that veggies are not healthy during the first trimester. Look into La Leche League and practice the 5S's on infants of friends and relatives. Your significant other can be a baby whisperer.

Unfortunately, I am that long-term vegan who is trying to switch to a carnivorous diet. For 8 years my diet has been nothing but pressure-cooked beans and vegetables with brown rice. I have been following your suggestion of adding raw vegetables and fruit into my diet to try and introduce beneficial bacteria (mostly unwashed cucumbers from our garden and store-bought apples). I am anxious to add yogurt into the diet but I am sure that it will cause my autoimmune joint condition to flare up. Does it sound reasonable to start yogurt by maybe eating a teaspoon once a week and incrementally increasing that amount to try and re-develop a tolerance? By the way, the menthol works surprisingly well at reducing some of my inflammation. I still need to find castor oil and give that one a try as well. Thanks.

Hi Dr Ayers,Thankyou for all your great info. I have have an allergy to fish, and a few other things (i have posted a question before) and have started taking fish oil for the first time,which i've found i can tolerate. I've been increasing the amount, but now im finding im getting quite red around my eyes, sweating at night, and my skin is getting drier. These are symptoms i had a few years ago when my diet was terrible and i had eczema. I'm wondering if it might be due to my body reacting to the fish oil. Do you think I should carry on taking the fish oil, or give it a break and see if the symptoms settle? I was hoping i could boost my omega 3 and settle my chronic inflammation,cheers Marley

Marley,About 20% of food allergies are actually due to an immunological response to a food molecule, so in most cases the "allergy" is actually just a food intolerance due to inappropriate gut flora.

In you case, you may actually have developed an allergy to some fish molecule that is also present in fish oil. You could probably get around it by using distillation purified DHA and EPA.

I think of the omega-3s as temporarily reducing inflammation while I work on the source. I can test to see if symptoms are due to inflammation by increasing my omega-3s until the symptoms are gone. In your case, it would make sense to eliminate the causes of your inflammatory symptoms, so that you don't need the omega-3s. Work on the rest of your diet and get rid of the major sources: vegetable oils, grains/starch/sugar/HFCS. Then get your gut flora in shape, to stop the basis for the allergy.

You can get a slight omega-3 impact from freshly ground flax seed, but men process only a tiny fraction to DHA and EPA.

Dr. Ayers,In reviewing some of your previous posts I came across your comment that another name for inflammation is metabolic syndrome. It then occurred to me that because of the association of metabolic syndrome with low HDL cholesterol and high triglycerides, the ratio TG/HDL would be an excellent commonly available measure of the degree of inflammation.

Inflammation stimulates synthesis of endothelial lipase (EL) by endothelial cells, and the favorite substrate of EL is HDL phospholipids. Activation of EL by inflammation results in catabolism of HDL and increased TG. The mechanism by which inflammation increases the ratio TG/HDL HDL seems to be well established.

I did get my vitamin D levels tested and the number was 46. I am taking 5,000 IU of vitamin D3 each day now along with calcium ascorbate, so hopefully that will make a difference. The full-fat yogurt will be my first source of saturated fat in 8 years. So I will try a teaspoon each day to start with given my hypersensitive immune system. Will let you know how I do. Thanks again.

Jack,I hope that I actually said that metabolic syndrome is another name for inflammation, i.e. metabolic syndrome is one of the many manifestations of inflammation.

I am sorry that I don't spend much time looking at serum lipids, because they don't seem to actually be that important, in contrast to inflammation. I don't think that the relationship between HDL and triglycerides is that straight forward. Dietary carbohydrates are a major determinant of triglycerides as well as inflammation. I also don't think that there is a direct relationship between HDL and inflammation. So, I don't think that TG/HDL is going to tell much about inflammation.

CRP is the typical tool for measuring inflammation and inflammatory interleukins are also sometimes used. I think that a better measure would be heparin saturation of serum proteins.

Thanks for the response Art, you are so generous with your time and advice. That makes sense what you say, I have been working on my diet the past 10 months and my "allergic" symptoms have been really good ie. no eczema,asthma,dry skin, and i have started to tolerate a few nuts i couldnt eat before. It has only really been when i have started the fish oil that they have returned. Do you think taking the fish oil is making my body more inflamed? Im undecided whether to keep taking them and hope my body gets used them, or stop altother. Although, as you suggested, maybe a stronger distlled fish oil may mean i can take less.Thanks again

Marley,I wouldn't bother with the fish oil until the general inflammation is under better control and you have your gut flora healthy. If you do have an allergy, then taking the fish oil isn't going to be helpful. So focus on getting your other fats in line. More saturated fats, eliminate vegetable oils, use olive oil/ coconut oil/butter/eggs. Then try probiotics, pectin (e.g. apples) and inulin (e.g. leeks).

The distilled fish oil DHA/EPA aren't necessarily stronger, they are just less contaminated with other stuff, such as fish antigens.

Thanks Art, what a quick reply. Looks like it is time to go to bed in the US! (We are in New Zealand). I will try cutting out the fish oil, and work on those things. We are lucky here to have a butcher with great organic beef (they boast it has 3x more omega 3 than fish but i havent seen the test results) and a source for free-range pasture fed chicken eggs, so those might be a good source of omega 3.Will keep you posted

Anonymous,I think that if one has been eating a healthy anti-inflammatory diet, such as I recommend, then there is not much to avoid for allergy purposes. I mention the vegetables as unhealthy early in pregnancy, because the only thing separating the growing fetus from toxic phytochemicals in common food plants is the mother's chemical detoxification system (P450s, glycosylating enzymes) in intestines and liver. That's the point of morning sickness, to avoid eating plants and to evacuate the stomach in response to plant smells.

Merrybee,I still think that your difficulty eating red meat is just a matter of getting your gut flora adapted and getting your bile system adjusted to eating more fat. In both cases it is just a matter of starting with small amounts and then gradually increasing.

It is hard to imagine what in the meat is actually causing the problem. Have you tried eating papaya (papain) or some other source of protease at the same time as the beef? Perhaps it is the iron content.

I suspect that your gut flora is just limping along and doesn't have enough diversity to adapt very quickly to any change in food. So try to get dairy established to eliminate lactose intolerance and then develop probiotics and add lots of different types of local veggies as a source of new bacteria.

Dr.Ayers, I recently had a gut flora test and the results showed that Geotrichum was elevated and Candida slightly elevated. I was not that surprised, as I have taken the birth control pill and antibiotics in the past. What do you generally recommend in terms of re-establishing a good gut flora balance? RegardsTina

My granddaughter (now 9 months old) developed severe colic. She was totally breast fed. The lactation consultant knowing our family history, suggested that my daughter in law stop gluten and dairy. In 3 days the colic stopped. Not exactly a controlled study, but it is interesting in light of your post. My son and his wife have continued to stay gluten/dairy free as they both felt so much better.

Hi Tina, a few years ago I had a stool test showing an overgrowth of Geotrichum Candidum. I used a product called ProEnt-2, two bottles worth, at 2 caps 2x a day, taken with fatty foods. I also took a series of probiotics by Interplexus. No sugar, and no flour.

The follow-up stool test showed the fungal infection had cleared, and the amount of "good" bacteria had risen.

Kathy,This is the way that I think about conception, pregnancy, birth and lactation. The whole process is orchestration of inflammation by estrogen and progesterone.

A fetus is foreign matter and the immune system typically responds with inflammation and expulsion. Conception or build up of the uterine lining requires suppression of inflammation. Birth and breakdown of the lining is stimulated by inflammation and suppressed by NSAIDs.

Lactation is stimulated by inflammation during birth, but cessation of nursing can also produce inflammation. Since inflammation and depression involve the same inflammatory cytokines, postpartum depression is not surprising and its response to NSAIDs makes sense.

Preeclampsia is high blood pressure plus loss of proteins into the urine. Proteins leak out of the blood when heparan sulfate is lost from the lining of the blood vessels in response to inflammation. I think that preeclampsia is caused by inadequate maternal supplies of omega-3 fatty acids (DHA) that are quickly depleted by a growing fetus.

Women build up reserves of all that is needed to make a baby for the first trimester. During this time women usually have an aversion to vegetables and this adaptation encourages the pregnant women to avoid most vegetable for the first trimester to avoid potentially harmful plant phytochemicals. Women who are eating poorly, e.g. the typical American diet, are also less likely to have a functional detox system in their intestines and liver, and are more prone to the natural toxicity of plants.

I hope this addresses most of your questions. Please ask again, if it is helpful.

Tina,I think that a major benefit of the cultural adaptation of using herbs and spices is the impact of these combinations of phytochemicals on pathogenic gut bacteria and fungi. Most modern diets contain minor amounts of herbs and spices as mild flavoring, whereas the traditional use is perhaps ten times the quantity.

We don't eat enough herbs and spices, and we over process our foods to the elimination of beneficial contributors to our gut flora.

The healthy gut continually sloughs off its surface and provides the possibility of regenerating a healthy gut flora. I think that in many cases, all that is necessary is to eat a healthy diet of unprocessed food and enjoy ample fresh herbs and spices.

Michelle,Thanks for the input from your own experience. I think that the ProEnt-2 is a combination of herbs to provide essential oils that modify gut flora. These simple chemicals are very potent, but are under utilized in medicine, because they are unpatented.

Peppermint oil, for example is more potent that most drugs for treating inflammatory bowel disease.

Love the post Dr. Art interesting as well as amazing. BTW my personal milk dairy allergy I have fixed with success ! The last time I had contacted you about my allergy it had been 4-5 months sense I touched it, but the first thing I did was take your advice about Greek yogurt and upping the intake ! No Reaction ! :) I also found a product by Charles Pouliquin called Pro flora = 22 cups of yogurt of probiotics used it and introduced Whey protein, and have no symptoms sense. I digest well, no bloating, dierehha, gas etc. I am Allergy free , I also ran out so for the past month I have been still using whey with success . Thank you again for helping . Pro Flora : http://us.cpoliquin.com/ProductDetails.asp?ProductCode=PROFLORA+EXC+DF+CAPS

You say "fresh herbs and spices" -- does that mean, for instance, that fresh chopped basil is better than dried basil? I like to make curries and other spice-heavy foods, but most often use dried spices.

Anonymous,Many of the chemicals that are advantageous in herbs and spices are volatile and are gradually lost by evaporation during storage. It is always best to freshly grind herbs and spices during meal preparation. Unfortunately, I don't always have the herbs growing in my garden or I am not in the mood to grind, so I just use what I have available. It isn't going to make a big difference. I think that it is more important to enjoy the food preparation and not sweat the details.

High starch/grains/sugar and vegetable oils will shorten your life. Dried basil or peppers will not be as tasty as fresh, but are still good for you.

Dr. Ayers, my son is two weeks old and has had "colic" since he was a few days old. He has severe reflux and is on previcid. He also has constant gas issues. The gas wakes him throughout the night. I removed dairy from my diet two and a half weeks ago. Currently I am breastfeeding and supplementing two-three bottles a day of hypoallergenic formula in hopes to ease some of his gas issues. Nothing has changed. I feel hopeless as my baby is miserable constantly. My three year old daughter had the same issues as an infant and was colicy for almost five months. I a determined to make my son feel better. Do you have any suggestions? Thank you.

Anonymous,Colic must result from several different sources and the candidates would include maternal antibodies transferred to the baby in utero and the corresponding food antigen transferred through mother's milk, and inflammation of the baby's gut by gut flora developed in response to formula.

What were the baby's stools like when the colic developed? Had formula already been introduced? Did your baby get plenty of your colostrum?

The colic may not be an immunological response, but rather a response of the gut flora to nutrients that you provide. For example, formula based development of adult gut flora could be killed off by mother's milk and cause colic. Alternating formula and mother's milk (of any type) would cause the problem bacteria to grow and be killed off in cycles.

So, my hunch is that the initial colic was due to milk Neu5Gc antibodies, but subsequent use of formula to avoid the cow's milk Neu5Gc in your milk, produced formula-based colic before the Neu5Gc could be depleted from your milk. It is also possible that the formula used contains Neu5Gc, since it may be made from hydrolyzed cow's milk proteins and lipids.

Mother's milk is always better than formula (even if the baby is already transitioning to adult gut flora because of prior formula exposure,) so keep nursing and pumping to keep up your milk supply. Most doctor's are more comfortable with formula use than nursing, because they have more control with formula, so you can expect the doctor's answer to be just changing formulas until one works.

In the mean time, work on your own diet to reduce your stress. Check out my diet recommendations. They are also helpful to reduce postpartum depression. Also note that you have to keep your vitamin D up to provide your baby with adequate levels through your milk.

Around 6 months of age, my daughter was diagnosed with nodular lymphoid hyperplasia. This was after many months of colicky symptoms, very little sleep, bloody diapers, elimination of dairy/soy/wheat/etc from my diet, trials of different "hypoallergenic" formulas, and the list goes on. I also became depressed because of the stress, hormones, lack of sleep, being trapped in my house with a screaming baby, etc.

We both are in a much better place now. I would like for my daughter to have a sibling, but I'm not sure I can go through that again.

After reading some information on this site, I'm thinking that I dont have the best "gut." As a child I had multiple ear infections treated by antibiotics. I took a birth control pill for many years.

I'm thinking I should go on an anit-inflammatory diet, increase omega 3s, inulin, vit D, pectin, saturated fats and probiotics. However, this all seems a little overwhelming. Where do I start? Should I get any tests done to check for yeast overgrowth?Thanks for your help.

Anonymous,I think when one is thinking about getting pregnant, female (or sperm contributor) is the right time to think about shifting to a healthy diet.

I think that the easiest way to get on a diet that will enhance the chances of getting pregnant and having the fewest problems during and after pregnancy is to:1. Find the healthy diet that is suitable for the whole family before, during and after pregnancy. I outline that diet on my blog, but it is a typical low carb diet with saturated fats as the major calorie from meats, fish, eggs and dairy.

2. Get a book with recipes appropriate for your new diet, e.g. Drs. Eades books: "The 6-Week Cure for the Middle Age Middle."

3. Practice the recipes casually before you shift to your new diet.

4. Read about my experience doing The Cure. Realize that the point is to shift to the new diet over six weeks. You can also lose a few pounds and get more fit, as appropriate.

6. Spend six weeks shifting the whole family to the new diet. Unhelpful eating behaviors, such as evening snacking, soft drinks, excess alcohol, should be made obvious and can more easily be managed on the low carb diet that eliminates hunger and craving for carbs.

7. If your initial blood work showed low serum vit.D, increase your vit.D3 supplement, e.g. 5,000 IU/day. A this point, you can also start using probiotics, e.g. full fat yogurt with live bacteria, pectin (apples) and inulin (leeks). You should have normal (no constipation) bowel movements and should have no food intolerances.

I seem to be intolerant to Whey protein powders (loose stools). The brand I take is Dymatize All Natural Whey Protein, sweetened just by a little Stevia and with no artificial flavors.

Do you have the same point of view about whey protein intolerance i.e. lack of intestinal flora to digest the proteins? Do you think it's a temporary problem and could be solved persevering but reducing doses temporarily?

Hi Marco,Shifting to straight protein for a meal, e.g. whey, would be expected to disrupt the gut flora, because the whey should be completely digested in the small intestine and leave nothing to support lower bowel gut flora.

There also may be more lactose present in the whey than you can digest and that may contribute to a major shift in your gut flora. I would expect your gut flora to adjust fairly quickly and addition of food with pectin and/or inulin should produce normal stools. The whey shakes in the Eades 6 Week Cure Diet are also supplemented with cream, and each day also includes a low carb meal that should help to stabilize the gut flora.

Whey is temporary to shock the gut flora, and is not balanced nutritionally by itself. I expect loose stools when I shift to whey shake meals. I adjust in a couple of days.

This may as good a place as any to bring the following article to your attention. It's about the pervasive positive role of 'good' bacteria in human health and opens with a tale of almost miraculous cure by fecal transplant.

so the million dollar question... i've struggled with chronic GI issues for years. diagnosed with everything from ibs to crohn's. have had multiple runs with different antibiotics. it would seem the most effecient way to restablish my gut flora is with a stool transplant. i've actually concerned doing this using my 2 year old son's stools (seems he would be a perfect donor). thoughts?

Anonymous,Fecal transplants are complex and I am not aware of a lot of published info on the factors to consider. One of my readers posted a DIY procedure based on that used in a clinic that performed fecal transplants.

I think that the DIY procedure used antibiotics to purge the remaining gut flora in the recipient prior to transplant. I would probably try a PEG total bowel irrigation and EDTA, similar to that used for stripping biofilms in a treatment for autism, that I discussed.

I guess your son sounds ok as a donor. I would make sure that his diet was as diverse as possible prior to the transplant and displayed no food intolerances.

I think that fecal transplants should be simple, inexpensive, safe and effective as support for many diseases. I just wish that the medical industry would take pity on the public and make cheap approaches to health possible by providing the information needed.

Hi Dr. Ayers --Again off-topic, but I thought you might be interested in the following article that says multiple sclerosis and gut bacteria are connected. http://www.sciencedaily.com/releases/2010/07/100719162643.htm

Since following your blog, it is amazing to see how gut flora influences disease or health. I really appreciate your work.

Cassandra,You reference another article on the impact of gut flora on IL-17 secreting T cell populations that mediate autoimmune diseases. There is evidence that one group of bacteria stimulates the production of the immune cells that mediate the autoimmune attack on tissues, whereas another group of bacteria are needed to block autoimmune attacks and produce self tolerance.

A big missing piece is how the intestinal cells regulate different bacteria in the gut to produce a gut flora that provides for the development of the gut and the gut associated immune system.

a little OT, but had a dilema:Where exactly on pubmed (i think you mentioned) can I find the protein sequencing database?

I'm trying to put my finger on how certain lectins make it to the blood stream. Does this happen in the same way as auto-antigens are created, ie. binding through heparin/ basic triplet combination in gut/systemic cells, then internalization, then making its way to the blood stream? or am I on the wrong track. Do lectins have a basic triplet?

This is coming from a grain/lectin problem causing angle where I am trying to tie all the issues together, so as I can explain it relatively simply to large groups at a time.

I remain skeptical about lectins moving from the gut and I would expect minimal impact if they did spread throughout the body, because of the abundance of glycoproteins carrying the sugars to which the lectins bind. It does not make sense to me.

If I assume that the lectins move from gut to other body tissues, then they must transit the intestinal epithelium and move to the blood or lymph ducts. Lectins can bind to surface receptors with appropriate sugars and this could cause internalization of the lectins. But then the lectins would be degraded within lysosomes/endosomes. Alternatively, the lectins could catch a ride with fats on chylomicrons that get transported to the lymph ducts of the intestines and are dumped into the blood stream. I don't know how they would get out of the blood, but perhaps they bind to some blood cells that move about.

I doubt that lectins use the heparin-interacting system, otherwise they would be allergens.

Protein sequences can be found by going to the PubMed parent site, NCBI (National Center for Biotechnology Information), picking the protein database and then searching for the protein by name and organism, e.g. wheat lectin. The protein sequence will be displayed at the bottom of the entries in a single letter per amino acid format. You can also download the 3D structure for many proteins, but you will also need to download the viewer (CN3D) for your browser.

Hi Dr. Ayers"how do lectins get into the blood?" thats exactly what i'm trying to find out.

It 'sounds' like there are plenty of studys showing the effect of dietary lectins in the body, and is a widely accpepted notion in the paleo-sphere

A few quotes from studies:"Because of their resistance to digestive, proteolytic breakdown,the luminal concentrations of lectins can be quite high, consequently their transport through the gut wall can exceed that of other dietary antigensby several orders of magnitude"

"WGA and lectins in general bind surface glycans on gut brush border epithelial cells, and the damage they cause to these cellsinterferes with digestive/absorptive activities, stimulates shifts in bacterial flora and modulates the immune state of the gut"

and interestingly:"Although no direct human experiments have been conducted evaluating dietary WGA passage into systemic circulation, there is substantial evidence to indicate that this event occurs since serum antibodies to WGA are routinely found in normals[218, 219] and in celiac patients [219]." - these from Cordains: Cereal Grains:Humanity’s Double-Edged Sword.Cordain references lectins damage a lot, but uses the same couple of studies.

"Lectins can also be transported through the gut wall into the blood circulation, where they directly influence peripheral tissues and body metabolism through the binding to glycosylated structures, such as the insulin receptor, the epidermal growth factor receptor and the interleukin 2 receptor [57-65]" - from Agrarian diet and diseases of affluence – Do evolutionary novel dietary lectins cause leptin resistance? BMC Endocrine Disorders 2005, 5:10 doi:10.1186/1472-6823-5-10

While a bunch of in-vitro test seem to show lectins, especially WGA, binding in to a bunch of receptors in the body, I cant get down any exact pathway of entry and from my search, nothing really telling of getting dietary lectins in the blood and transport. The 2 studies mentioned above are the most popular, and this is another from pubmed:Lancet. 1998 Dec 5;352(9143):1831-2Identification of intact peanut lectin in peripheral venous blood.Wang Q, Yu LG, Campbell BJ, Milton JD, Rhodes JM.

Sorry for such a long post, just trying to get to the bottom of this and value your input highly.Do you have any further thoughts?

shows activity by tiny amounts of WGA in GI epithelium cells such as inflammation, as expected, but no further evidence of moving into blood streamWGA seems to bit it as far as research of moving into blood go's, especially for cancer-drug related transport, but even they say evidence is 'scant'

Steve,After looking at the references for WGA transit of the intestinal epithelial layers and transit to the blood, I am unconvinced. In most articles, a model system is used without overlying mucin and even with these artificial layers, the transit is less than 0.1%. I think that WGA would be destructive to naked human cells, but I think that the healthy gut protects itself from coming into contact with dietary WGA.

I think that wheat/grain gluten is a problem for many people, but I don't think there is evidence that dietary WGA is a problem. The presence of antibodies to WGA, means that WGA is presented to the immune system in the gut, but that is no indication that WGA ever gets out of the gut.

As you indicate, no one has an explanation for WGA transit from food to blood and the evidence for transit is weak. I just don't think that lectins in food are a big deal for humans. Cultural food preparation practices minimize any real risks.

That's my view. I am fairly easy to convince to another view, but I haven't seen anything convincing.

my wife has a light Mitral Valve Prolapse.Some days ago she's contracted a tonsillitis, which we've found to be bacterial (she has been tested with a throat swab and she's been found POSITIVE to Streptococcus).

She's had some days of fever, but now her temperature is normal.

The problem is that, as she suffers from long-term constipation (slowly getting better with large doses of KEFIR, she also hasn't her appendix anymore), she isn't very keen on antibiotics, unless really essential or crucial for life.

I've also read antibiotics aren't recommended anymore for the prevention of endocarditis in case of dental procedures.

But is it the same when you KNOW you're surely infected by the Streptococcus?

Any suggestion would be very appreciated.

Thanks a lot.

Marco

p.s. - our daughter (5 y.o.) has never taken antibiotics in spite of the fact her paediatrician has prescribed them each winter at the first coughs...

Hi Marco,I would say that you wife's first health priority is reestablishing a functional gut flora, as measured by normal bowel stools (no constipation) and no food intolerances.

Kefir and other probiotics that supply fermenting bacteria only provide for a small fraction of the hundreds of different species of bacteria in the healthy gut (gut flora). They are a good start, but the other supporting gut bacteria needed to be provided and fed, by eating lots of different fresh, uncooked vegetables with some clinging bacteria.

Excess hygiene is a problem in acquiring missing gut bacteria, because the only way to acquire these bacteria is by contact with healthy people, animals and food. That is why people from rural, farm backgrounds have fewer diseases than modern inhabitants of clean cities.

Your wife will be protected from heart valve infections by improving her immune system with healthy gut flora. The anti-inflammatory diet that I recommend plus added diverse soluble fiber, e.g. fruits and veggies with pectin (apples) and inulin (leeks), and plenty of herbs and spices, should build up a complete gut flora and reduce tonsilitis.

Strep and Staph are common infections, but these bacteria are around all the time. A healthy immune system avoids infections, as well as allergies and autoimmune diseases.

Antibiotic use should always be avoided if possible, but if it is necessary (probably not for dental work), then a strategy needs to be found to reestablish gut flora.

Perhaps people should store their gut flora when they are healthy, so that they have a starter gut flora to be replanted after antibiotic treatment.

the problem with antibiotic use is that every infection has some complications.So people, to avoid complications keep taking antibiotics or other drugs, with the result to have more complications.

It seems to me antibiotic use is based on fear.

But is the remedy worse than disease?

My wife, after a week, continues to have symptoms (pain in her throat, pain when swallowing and swollen glands in the neck) from her tonsilitis, so, after reading the consequences of strep throat (scarlet fever, rheumatic fever, glomerulonephritis, otitis media, heart valve failures, etc.), now we're hesitant.

Antibiotic or not antibiotic?

On this site I've found no particular need to take antibiotics(http://www.familydoctor.co.nz/index.asp?U=conditions&A=32708).

Do you think the risk of complications to be real or it isn't worth 10 days of eritromicin?

Hi Marco,I agree with the website. Chance of complications is slim, but the infection has persisted for a week. That means that your wife has an inefficient immune system. I would guess that she is short on the major immune component Th-17 that develops in the gut associated lymphatic tissue. The Th-17 cells are needed to attack infecting bacteria. That attack needs to be balanced by the Tregs that are also produced in the GALT. In both cases, the problem is in the gut flora that stimulate the GALT. The first step to help the gut flora would be probiotics and/or fermented dairy products with live bacteria.

If it were me, I would continue vit.D3 and vit.C supplements, eliminate fish oil, eat more antibacterial veggies, i.e. herbs/spices, garlic, and gargle with salt and vinegar solution. The anti-inflammatory diet that I recommend is a good approach to develop a fully functional immune system and to compensate for minor additional sources of inflammation, but if an infection already exists, it is better to remove the inflammation reducing omega-3 fish oil.

In reference to the discussion of whether or not lectins transit from foods to blood or other body tissues, there are other pathways, such a vaccines which are injected directly into the body. Ingredients such as peanut and sesame, etc. can be used in the culture, fermentation or buffer mediums for vaccines and they don't have to be disclosed as they are considered "inactive."

Nick,Common food allergens used in the production of vaccines sounds like an urban legend. There is simply no need or use for those materials and they would have to be acknowledged.

Even if lectins were included in vaccines, they would be present in miniscule amounts and they are not toxic enough to have any impact unless they are spread through a substantial amount of tissue. But lectins have a high affinity for their target sugars, so they would be immediately stuck at the injection site and have no impact.

I would not worry about lectins in vaccines. At the same time, I have carefully evaluated every immunization that I permitted to be administered to my daughters, and that was very few. The only exception was when I planned to have my young daughters travel through some of the rural areas of Southeast Asia.

Also note that there are very few true food allergies -- most are food intolerances due to maladapted gut flora. In a recent study, less than 20% of food responses judged by physicians to be food allergies were actually immunological allergies.

Dr. Ayers said: "Also note that there are very few true food allergies -- most are food intolerances due to maladapted gut flora. In a recent study, less than 20% of food responses judged by physicians to be food allergies were actually immunological allergies."

I'm not sure this distinction matters to parents of children with life-threatening reactions to peanuts. It is more than an urban legend that peanut oil is used in vaccines.

"Peanut oil made its debut in injected meds at the end of WWII. An army doctor invented a method for prolonging levels of penicillin in the blood by mixing the drug with refined peanut oil. As the body metabolized the oil, the drug was slowly released. Doctors quickly recognized that the oil had sensitized some people and moved to better refine it. Peanut oil thus gained a history of use so that by the 1960s, peanut oil was a simple choice for Merck to include in its new aluminum based vaccine additive, Adjuvant 65-4. Since then, peanut oil has been a common ingredient in vaccines.

Labeling the oil on vaccine package inserts has also been debated. While it makes sense to warn consumers of sensitizing ingredients, corporate law and ethical guidelines have been at odds for years over whether consumers really need to know. Proprietary vaccine formulae are protected from Freedom of Information provisions in the UK, US, Canada. New guidelines from the European Medicines Agency recommend that consumers have a right to know – and yet, there continues to be no legal obligation for a maker to reveal this information. And why would they? The US government says trace proteins in peanut oil are safe."

Nick,You have done a bait and switch.You started with, "...whether or not lectins transit from foods to blood or other body tissues, there are other pathways, such a vaccines..." "used in the culture, fermentation or buffer mediums for vaccines" and ended up discussing peanut allergens found in vaccine adjuvants. I understand adjuvants and have used them in my research. They are not the same as culture media or buffers.

There is also no justification for using peanut oil containing peanut allergens in adjuvants. That is just sloppy and unnecessary.

But there is no need for a tirade on my blog. I am sympathetic. All allergies are unnecessary and result initially from bad diet choices that translate into compromised immune systems. Avoidance of the allergens is not, in my opinion, going to provide a cure. Restructuring gut flora and repairing immune systems makes a lot more sense. Extreme allergen hygiene is not the long term solution and is missing the point, since it just leads to more intense food processing for more increasingly compromised individuals. I seek a cure and prevention, and spend less effort on elaborate treatment.

Sorry Dr. Ayers, a bait and switch was not intended, I was merely pointing to more evidence that vaccines (and even other things that are injected like antibiotics) provide another pathway into the body besides the digestive tract. When they are injected directly, the body's normal defenses are bypassed.

There is not tirade here, just pointing out that allergenic foodstuffs ARE used, as culture, fermentation or buffer mediums for injectible medicines and are also used as adjuvants. Sloppy? I certainly agree!

When an epidemiologist wants to test a sample of manure or food for a particular pathogen,what is the procedure?How do they isolate one type of bacteria from the sample?Do they culture the bacteria in a growth medium?If they do, does the bacteria sometimes adapt to the new growth medium by taking in new bits of DNA or deleting some of it's DNA?Does the choice of growth medium affect the bacteria that they are trying to grow?

Miguel,The biggest problem in trying to detect bacteria is sampling. It is best to combine sample from many locations, to avoid missing or misrepresenting the presence of an organism. Then you can suspend everything, remove the debris and streak part of the sample on a selective agar medium for the desired bacterium to grow.

Of course, you could also extract the DNA and use PCR to amplify specific DNA sequences to enhance your ability to detect a particular bacterium.

Transfer of DNA between bacteria is dependent on the concentrations of the bacteria and conditions that would facilitate transfer. Those conditions don't occur during sampling, but they do occur in biofilms.

The point of the steaking procedures on the selective media is to isolate each bacterium from others during the process. This would avoid gene transfer, although mutation can occur, but at a low frequency. The medium usually does not enhance mutation or gene transfer and the bacteria grow into clones.

I have a hypothesis about milk; that the cows milk we drink is not necessarily an ideal food for calves either.What makes it so? What protects calves against toxic efects of casien and casomorphins?Perhaps the immunological role of colostrum extends to protection against toxins in milk.Colostrum is a vaccination (literally! from vache = cow) against what comes after; it conditions the immune system against the immunosuppressive peptides from milk. Perhaps in part by stimulating bifidobacterium. A partial proof of this hypothesis would be to use the new colostrum peptide products (pepticol) to treat problems caused by premature exposure to cows milk in infants. The conditions that they are intended to treat, though not directly attributed to cows milk in the literature, are very likely to be caused by such.

Dr Ayers, have you read "The Devil in the Milk" by Woodford?This almost exclusively focusses on beta-casomorphin7 (BCM7) from uncultured A1 milk as a cause of disease. A very narrow focus which nonetheless yields enough research and evidence of all sorts to fill an entire book. I really liked this comment of yours; "Intolerance of fat may result from depletion of bile by inadequate dietary fat. Many people on modern diets suffer from inadequate saturated fat. The biomedical literature never actually documented that saturated fat had health disadvantages and inflammatory polyunsaturated vegetable oils were substituted. Low fat foods are more of a problem than the whole foods that they replaced."The belief that SFAs are harmful is one of those things, like the old belief that the earth was flat, that has been able to survive despite the growing lack evidence to support it, and despite the fact that people knew better in the not-so-recent past.Look at the crowd scenes in the documentary footage on the history channel; we know those people ate bread and dripping, lots of saturated fats, and that deficiency diseases of PUFAs were not unknown. So where were the obese people and the type 2 diabetics? You'll only find obesity among those (Göring, Churchill, Malenkov) who had access to sweets and refined carbohydrates in amounts approaching those everyone has access to today.

I agree with the colostrum theory. There is lots of stuff out there in the alternative med circles about colostrum supplements, especially for inflammation. One of the things I haven't tried! (of which there are getting fewer!)

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About Me

I grew up in San Diego and did my PhD in Molecular, Cellular and Developmental Biology (U. Colo. Boulder). I subsequently held postdoctoral research positions at the Swedish Forest Products Research Laboratories, Stockholm, U. Missouri -Colombia and Kansas State U. I was an assistant professor in the Cell and Developmental Biology Department at Harvard University, and an associate professor and Director of the Genetic Engineering Program at Cedar Crest College in Allentown, PA. I joined the faculty at the College of Idaho in 1991 and in 1997-98 I spent a six-month sabbatical at the National University of Singapore. Most recently I have focused on the role of heparin in inflammation and disease.